Provider Demographics
NPI:1609921832
Name:HOGAN, PATRICIA L (ARNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:HOGAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34581
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1581
Mailing Address - Country:US
Mailing Address - Phone:509-241-7349
Mailing Address - Fax:509-241-7628
Practice Address - Street 1:200 15TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5260
Practice Address - Country:US
Practice Address - Phone:206-326-3000
Practice Address - Fax:206-326-3603
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00019029163W00000X
WAAP30003473363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9646936Medicaid
WAG8857054Medicare PIN
WAQ56105Medicare UPIN
WA9646936Medicaid